HEALTH WORKFORCE SHORTAGES AND INTERNATIONAL MOBILITY IN THE EU

Size: px
Start display at page:

Download "HEALTH WORKFORCE SHORTAGES AND INTERNATIONAL MOBILITY IN THE EU"

Transcription

1 HEALTH WORKFORCE SHORTAGES AND INTERNATIONAL MOBILITY IN THE EU An overview of three cross-cutting trends from the perspective of the WHO Code of practice and its implementation in the region 1

2 Coordination: Giulia De Ponte Contributions: Giulia De Ponte, Linda Mans, Monica Di Sisto, Remco van de Pas Editing: Taalcentrum-VU Design: February 2014 EU Disclaimer This publication has been produced in the framework of the project Health Workers for all and all for Health Workers DCI-NSAED/2011/106, with the financial assistance of the European Union. The contents of this publication are the sole responsibility of the project partners and can under no circumstances be regarded as reflecting the position of the European Union. 2

3 Content - Foreword The initiative health workers for all and all for health workers : towards a sustainable health workforce 4 - Introduction - the present situation in the region 6 - Chapter 1 Health workforce planning capacity across the European Union 9 - Chapter 2 Fiscal space for health workforces in the context of the economic crisis 13 - Chapter 3 Is the health workforce a tradable commodity? 18 - Conclusions 25 3

4 Foreword THE INITIATIVE HEALTH WORKERS FOR ALL AND ALL FOR HEALTH WORKERS : TOWARDS A SUSTAINABLE HEALTH WORKFORCE Health workers for all and all for health workers (HW4All) is a civil society-led advocacy initiative involving organizations in Belgium, the UK, Italy, Germany, Poland, Romania, Spain and the Netherlands. Through advocacy and campaigning, it contributes from within Europe to the development of a sustainable health workforce worldwide. With the support of health workers and citizens, it calls upon politicians and policymakers in Europe to implement the WHO Code of Practice on the International Recruitment of Health Personnel (WHO Code). 1 As the WHO states, the Code aims to establish and promote voluntary principles and practices for the ethical international recruitment of health personnel and to facilitate the strengthening of health systems. In this sense, it: establishes principles and represents a point of reference for a legal framework for the ethical international recruitment of health personnel; provides guidance on bilateral and international legal instruments; and promotes international discussion and cooperation regarding ethical international recruitment with a focus on strengthening health systems in developing countries against the threat of a brain drain from those countries. From the perspective of WHO Code implementation from within Europe and as a complement to work carried out at national level by HW4All partners this report presents a review of three cross-cutting issues relevant to WHO Code implementation at regional level: HRH planning capacity across the EU: Article 5.4 of the WHO Code recommends that all states should forecast and plan their own health personnel needs and strive to meet them without resorting to international recruitment. Chapter 1 of this report provides an overview of how the European Union is working to achieve this aim and of the tools currently available for this purpose. Fiscal space for health workforces in the context of the economic crisis: Chapter 2 questions the possibility for EU member states to take effective measures to educate, retain and sustain a health workforce that is appropriate for the specific conditions of each country (Art 5.4 of the WHO Code) in the context of the austerity measures currently being imposed on many national governments. Fiscal tightening brings with it the risk of restrictions on the capacity to train and retain personnel for future HRH needs, creating a potential for largescale future problems and an increase in the global shortfall. HRH mobility and trade in services: by adopting the perspective of health in all policies, Chapter 3 forges the link between the provisions of the WHO Code and the EU s approach to trade in services, which constitute two different approaches to the international mobility of health workers. 1 For the full text of the Code, see 4

5 The analysis presented in the following chapters recognizes the fact that the European Union s mandate on health is limited to supporting, coordinating or supplementing national health policies, while member states remain responsible for the definition of their health policy and the organization and delivery of health services. 2 Equally, however, the EU and its member states have a legal obligation to make their policies coherent with development objectives. 3 The recommendations at the end of each chapter therefore set out strategies for future action leading to a sustainable health workforce. This action is to be taken by HW4All partners and other stakeholders. 2 See The Treaty of Lisbon, Article 6 of the Treaty on the Functioning of the European Union, index_en.htm. 3 See The Treaty of Lisbon. The official term is Policy Coherence for Development. See more at: 5

6 Introduction THE PRESENT SITUATION IN THE REGION by Giulia De Ponte, AMREF Italy The demand for health care will increase dramatically as a result of Europe s ageing population. The number of people aged 65 and over is projected to almost double over the next fifty years, and this will happen together with an expected reduction in the availability of informal carers, as a result of changing family structures. 4 The increasing number of elderly people with multiple chronic conditions will require not only new care delivery models but also changes in skill mixes and new ways of working for health professionals. Most EU member states are currently facing critical workforce shortages, affecting certain health professions and medical specializations or geographic areas. These could be exacerbated in the future if no action is taken. The retirement of a large cohort of health professionals is drastically shrinking the EU s health care workforce and, by 2020, the annual percentage of European doctors entering retirement is expected to reach 3.2%. 5 A similar situation applies to the nursing workforce as, based on data collected by some member states, the average age of nurses employed today is between Young health professionals coming through the training system are still not sufficient in numbers to replace those who are leaving the profession. In Italy, 13,400 nurses were due to retire in 2010, while only 8500 nurses graduated in Germany is facing serious difficulties in training a sufficient number of graduates, Slovakia has insufficient nurses, midwives, physiotherapists, radiology assistants and paramedics, and Hungary faces serious bottlenecks in supply caused by cutbacks in the training of nurses. Unfilled specialist training positions are reported in Romania, France, Hungary and Austria. 7 The health labour market is not sufficiently attractive to members of the younger generations choosing their professions. Evidence from some countries shows an increasing turnover in the health professions, due partly to low rates of pay, but also to non-financial factors such as unsatisfactory working conditions. 8 The nursing workforce study Nurse Forecasting in Europe 9, confirms that all twelve European countries studied face problems of nurse burnout and dissatisfaction. The issue of work-life balance, in particular, is all the more relevant in the health care sector, where the participation of women in the workforce has historically been significant and is increasing European Commission, Commission Staff Working Document on an Action Plan for the EU Health Workforce, 2012, 5 ibidem. 6 Based on data collected from 6 MS: DE, DK, IE, FR, SE, UK. (http://www.euro.who.int/en/what-we-do/health-topics/health- systems/ health-workforce/facts-and-figures, PROFILE_2011.pdf 7 M. Wismar, C. B. Maier, I. A. Glinos, G. Dussault and J. Figueras (eds., 2011), Health professional mobility and health systems. Evidence from 17 European countries, Observatory Study Series No. 23, European Observatory on Health Systems and Policies, WHO Regional Office for Europe, Copenhagen. (http://www.euro.who.int/ data/assets/pdf_file/0017/152324/e95812.pdf) 8 For a more detailed analysis, see the Second Biennial Report on social services of general interest, 2011, 9 Nurse forecasting: Human resources planning in nursing, 10 European Commission,

7 Moreover, although skill levels are relatively high and working conditions are often demanding, overall wage levels in the health and social services sectors tend to be lower than in other sectors of the economy across the continent, 11 a factor which is of course related to the gender pay gap. The European Commission, in its Staff Working Document on an Action Plan for the EU Health Workforce, estimates that without further measures to meet these challenges, a potential shortfall of around 1 million health care workers will take place by 2020, rising up to 2 million if long-term care and ancillary professions are taken into account. This means that around 15% of total care will not be covered 12 compared to Table 2: ESTIMATED SHORTAGE IN HEALTH CARE SECTOR BY 2020 Health Professionals or other health workers Estimated shortage by 2020 Estimated percentage of care not covered Physicians ,5% Dentists, pharmacists and physiotherapists ,5% Nurse ,0% Total ,8% Source: European Commission Many member states also face the challenge of an unequal distribution of health professionals: the research project PROMeTHEUS 13 provides evidence from 17 European countries, confirming that there is an undersupply of health professionals in rural areas, for example in Denmark, Finland, France, Germany, Romania, and an oversupply of doctors in some urban areas, particularly in Germany, and an oversupply of nurses in Belgium. In terms of the international mobility of health professionals within the EU, the PROMeTHEUS study concludes that all 27 member states are experiencing migration of health professionals, with outflows rarely exceeding 3% of the domestic workforce. There are, however, significant differences in cross-border movements with a clear east-west asymmetry for doctors, nurses and dentists. In particular, although the overall EU enlargement in 2004 did not lead to massive outflows of health professionals from the newer member states to the EU15, the accession of Bulgaria and Romania to the EU in 2007 led to critical shortages in these countries due to out-migration, particularly among medical doctors. 11 ibidem 12 An Agenda for new skills and jobs: A European contribution towards full employment, COM (2010) 682 final. 13 M. Wismar, C. B. Maier, I. A. Glinos, G. Dussault and J. Figueras (eds., 2011), Health professional mobility and health systems. Evidence from 17 European countries, Observatory Study Series No. 23, European Observatory on Health Systems and Policies, WHO Regional Office for Europe, Copenhagen. (http://www.euro.who.int/ data/assets/pdf_file/0017/152324/e95812.pdf) 7

8 Health workforce shortages in some member states have also increased the reliance on the recruitment of health care professionals from outside the EU. National patterns of migration flows of doctors coming from outside the EU vary widely, with mobility especially prevalent from the major former colonial countries that are linguistically and historically connected to source countries. A survey of ten member states found that nearly 30% of all migrant doctors come from outside the EU in Austria, Belgium, Denmark, Germany, the Netherlands and Poland. This figure rises to 60% in France and Italy and to 80% in Ireland and the UK. 14 Currently, recruitment of non-eu health professionals appears to be decreasing, however, due to both stricter implementation of EU legislation and the changing economic context: the EU may, in fact, be by-passed by third country nationals who not only face problems in entering the EU, but who also prefer the US or Canada. In particular, there may be an upsurge in active recruitment by the US in EU member states, which could in turn exacerbate existing shortages in the EU Gilles Dussault, Inês Fronteire and Jorge Cabral (2009) Instituto de Higiene e Medicina Tropical, Lisbon, Migration of health personnel in the WHO European Region. 15 M. Wismar, C. B. Maier, I. A. Glinos, G. Dussault and J. Figueras (eds., 2011), Health professional mobility and health systems. Evidence from 17 European countries, Observatory Study Series No. 23, European Observatory on Health Systems and Policies, WHO Regional Office for Europe, Copenhagen. (http://www.euro.who.int/ data/assets/pdf_file/0017/152324/e95812.pdf) 8

9 CHAPTER 1 HEALTH WORKFORCE PLANNING CAPACITY ACROSS THE EUROPEAN UNION by Linda Mans, Wemos Foundation Member States should take effective measures to educate, retain and sustain a health workforce that is appropriate for the specific conditions of each country, including areas of greatest need, and is built upon an evidence-based health workforce plan. All Member States should strive to meet their health personnel needs with their own human resources for health, as far as possible. Art. 5.4, WHO Code of Practice on International Recruitment of Health Personnel One of the main purposes of health workforce planning is to respond to challenges in terms of balancing the demand for and the supply of human resources for health. 16 Given the rigorous nature of current budget constraints, health systems are under strong pressure to pull off this balancing act in a cost-effective way, while also making fundamental reforms to the way in which they deliver health care. Innovative solutions are, however, always dependent on a high quality motivated health workforce of sufficient capacity and with the right skills to meet growing health care demands. 17 European countries are facing similar challenges when it comes to the sustainability and affordability of their health systems. Many European countries still lack the tools to enable them to estimate present and future health workforce supply and demand. The limited availability of relevant indicators, the poor comparability of data at the national and international level and the scarce use of planning tools prevent many countries from developing adequate health workforce planning strategies and systems. While definite estimates of possible shortages of health professionals have been developed in only a handful of countries, it would nevertheless appear that, across Europe, the current supply and skills mix of human resources for health might not be adequate to meet future health needs. In addition, intensifying mobility flows (within countries and across countries) affect the structure and skills mix of the health workforce across Europe and need to be taken into consideration when ensuring the sustainability of the system. European enlargements, for example, have resulted in a substantial expansion of the pool of health professionals within the EU labour market and have increased economic diversity. Larger salary differentials and increased differences in infrastructures and in the use and availability of modern medical technology have further intensified health professional mobility. 16 In 2012 Matrix Insight and the Centre for Workforce Intelligence conducted a feasibility study on EU-level collaboration on forecasting health workforce needs, workforce planning and health workforce trends. The study is available at This chapter is based on this study. 17 Commission Staff Working Document on an Action Plan for the EU Health Workforce. Strasbourg

10 These challenges and trends have a clear European dimension, as they are widespread and shared across countries. European collaboration can help in addressing some of these common challenges, tackling interdependencies across countries. Recognizing the international dimension of the health workforce crisis and recognizing the key role of health workforce planning, the European Commission, together with other international institutions (e.g. WHO, OECD), has proposed policies and tools that aim to support national governments. 18 While there are important interdependencies across countries, which should be addressed through broad and comprehensive action, it is also important to recognize the complexity of health workforce planning. Not only does it involve multiple areas at the national level (such as labour market, education, health), but it also encompasses multiple levels of governance (international, European, national, regional and local). Each of the separate dimensions of health workforce planning is present at different governance levels and can draw on multiple aspects, such as the education system, for instance. Moreover, the governance mechanisms can differ across professional occupations and entities. For this reason, cooperation should take place at multiple levels and encompass multiple areas. 19 As a consequence, action needs to be cross-cutting, taking into account the development of human resources, education and training strategies, EU employment, social affairs, the internal market and cohesion policies. Policy initiatives should be aligned at the European and the national level (e.g. Social Agenda, Qualifications Directive, Working Time Directive, Roadmap for equality between women and men). While it may be difficult to identify the perceived purpose of health workforce planning and evaluate the availability of technical and financial resources, it is possible to assess whether sufficient data are available in a country in order to carry out model-based health workforce planning. From a data availability perspective, it is possible to conclude that there is significant scope for more countries to engage in model-based health workforce planning than is currently the case, and for countries already engaging in such planning to extend the reach of their current models. The extent to which the workforce planning process is institutionalized and integrated varies substantially across countries. With the exception of the Centre for Workforce Intelligence in the UK, there are few institutions in Europe dealing exclusively with health workforce planning. In most countries, the national Ministry of Health (or specific agencies therein) is responsible for health workforce planning. However, a range of institutions are usually involved in the planning process, including other public institutions such as Education and Finance Ministries, National Health Services, professional associations, health and social security insurers, and independent planning institutions. 18 Matrix Insight, p ibidem 10

11 Many countries lack a comprehensive health strategy and corresponding health workforce strategy, aimed at achieving predetermined health targets. Several factors explain the limited success of planning and implementation of health workforce strategies. 1. Lack of comprehensive national health strategies to clarify the long-term development of the health system. These include research allocation, system characteristics and workforce policies, which in turn can be influenced or informed by health workforce planning. 2. Low levels of stakeholder involvement. In many countries, workforce planning is not yet structured in an integrated manner, i.e. without the involvement of multiple stakeholders and multiple institutions, such as professional associations and education and training institutions. 3. Lack of strategic engagement of workforce planning institutions. In many countries, workforce planning is detached from decision making in the health system and in the education system. 4. No evaluation of workforce planning outcomes. In most settings, the outcomes of workforce planning and its impact on decision making at the national, regional or local level are not clear. EU Joint Action on Health Workforce Planning and Forecasting The European Union recognizes that collaboration can help countries face both the common challenges and the shortcomings of health workforce planning systems. European collaboration could help address what is sometimes referred to as the EU-wide health workforce crisis by providing support for national authorities, and by creating tools, methodologies, common definitions and indicators to carry out monitoring and analysis at the European level. The Action Plan for the EU Health Workforce, in particular, sets out actions to foster European cooperation and share good practices to improve health workforce planning and forecasting, to anticipate future skills needs, and to improve the recruitment and retention of health professionals, while mitigating the negative effects of migration on health systems. In April 2013 the EU Joint Action on Health Workforce Planning and Forecasting (Joint Action) was launched within the framework of the Action Plan. It has established a platform for cooperation between member states on forecasting health workforce needs and health workforce planning in close cooperation with Eurostat, OECD and WHO. The Joint Action addresses a range of different topics, such as data for improved health workforce planning and the exchange of good practices in health workforce planning methodologies. The high outflow of health professionals has provoked policy debates on the impact on health care systems in some member states, reinforcing the need for accurate and comparable data on mobility and migration flows in the EU to develop policy responses based on evidence. The Joint Action has therefore included a discussion on the applicability of the WHO Global Code of Practice in the International Recruitment of Health Personnel in the EU context. 20 In January 2014 the Joint Action organized a conference where policymakers active in the field of health workforce planning could meet and participate in the development of a European platform for networking initiatives and sharing expertise. In this context, HW4All 20 Partners of the Health Workers for All and All for Health Workers are actively engaged in this discussion. 11

12 was invited to organize a workshop on the global mobility of health workers. One of the workshop s objectives was to link the debate on health workforce mobility and WHO Code implementation with the debate on austerity measures in Europe: the WHO Code of Practice, in fact, promotes the creation of self-sustainable production of health professionals in order to avoid a heavy reliance on foreign health workers, thereby avoiding a brain drain. Drastic health budget cuts in European countries, however, are currently pulling in the opposite direction, jeopardizing the long-term sustainability of the health workforce in these countries, where the ageing of the population poses long-term challenges. HW4All introduced this topic by mirroring the experiences of African countries that have had austerity measures imposed on them by the World Bank and the International Monetary Fund (IMF) for decades and by reflecting on the link between budget cuts, an increase in health workforce mobility and the prospect of brain drain. Recommendations Data collection to monitor stock and flows of human resources for health is urgently needed. This needs to be done under EU leadership, as health workforce issues are interconnected and extend beyond national borders. The Joint Action discusses possibilities and responsibilities regarding data collection and information sharing. EU-wide information and data collection mechanisms should focus on: Developing common key indicators and comparable definitions; Collecting, analysing and reporting clear data on stock, flows, internal flows and different types of mobility; Collecting, analysing and reporting information on education and training capacity; Facilitating data and information exchanges with countries outside the EU; Publishing and disseminating good practices on health workforce planning methodologies; and Analysing the effectiveness of specific workforce management strategies. To rise above short-term policies on health workforce planning, longer-term strategic planning is needed: European member states as well as third countries should be encouraged to articulate policy targets for the self-sustainability of their health workforce. In this sense, countries that still rely on foreign-trained health workers should strictly implement principles of ethical recruitment as identified in the WHO Global Code of Practice. Member states should also apply appropriate strategies to integrate foreign-trained health workers. Such strategies could include (further) collaboration with organizations such as labour unions and representatives from migrant health workers to ensure that the rights of migrant health workers are equal to those of locally trained health workers. They could also include the development of an EU-wide portal, fed by national data collection institutions, to compare non-eu qualifications and to enable registrars to verify foreign qualifications. Member states should be encouraged to adapt education and training to the current and forthcoming needs of the health care labour market. For this reason, a strategic rethinking of the health systems and of education and training for human resources for health might be needed. 12

13 CHAPTER 2 FISCAL SPACE FOR HEALTH WORKFORCES IN THE CONTEXT OF THE ECONOMIC CRISIS by Giulia De Ponte, AMREF Italy The current financial and economic crisis is having and will continue to have an impact on the way in which EU member states implement the WHO Code of Practice. Since 2008, public debt in many European countries has reached levels perceived as unsustainable, fiscal deficit has become excessive and there has been a snowballing of debt, with a consequent rise in the risk premium on borrowing, principally in southern European countries. 21 Although countries in Europe have responded to this situation in various ways, most of them have adopted austerity policies, including large-scale cuts and public sector reforms. These policies were imposed on countries in need of financial rescue packages (i.e. Greece, Ireland and Portugal 22 ) as a pre-condition by the so-called troika (the European Commission, the International Monetary Fund, and the European Central Bank), but they have also been taken as a point of reference by other EU countries. In the context of the austerity packages implemented in , public spending on health fell both in absolute terms and as a share of total government spending in many countries, in spite of efforts to protect the health budget. 23 At the same time, sweeping government spending cuts have also been made in the areas of community services, education and social protection, 24 while Official Development Assistance budgets decreased in 2011 by approximately 3% in OECD countries. 25 These developments are impacting directly on the relationship between health workforce mobility and investments in health workforce development, which are at the heart of the Code of Practice. Employee wages, salaries and allowances account for 42.3% of public 42.3% of public spending on health in the 18 countries of the WHO European Region for which data are available 26 and policy in many countries has therefore focused on cutting salaries WHO Regional Office for Europe, Report of the Oslo conference Health systems in times of global economic crisis: an update of the situation in the WHO European Region, April, 2013, data/assets/pdf_file/0007/190456/healthsystems-in-times-of-global-economic-crisis,-an-update-of-the-situation-in-the-who-european-region.pdf 22 Marina Karanikolos et al., Financial crisis, austerity, and health in Europe, The Lancet, 27 March WHO Regional Office for Europe, Health, health systems and economic crisis in Europe. Impact and policy implications. Summary, World Health Organization, WHO Regional Office for Europe, Report of the Oslo conference Health systems in times of global economic crisis: an update of the situation in the WHO European Region, April, 2013, data/assets/pdf_file/0007/190456/healthsystems-in-times-of-global-economic-crisis,-an-update-of-the-situation-in-the-who-european-region.pdf 25 OECD (Organization for Economic Cooperation and Development) National Accounts online Database, Patricia Hernandez et al., Measuring expenditure for the health workforce: evidence and challenges, World Health Organization, 2006, 27 Mladovsky P, Srivastava D, Cylus J, et al., Policy summary 5. Health policy responses to the financial crisis in Europe, World Health Organization (on behalf of the European Observatory on Health Systems and Policies), data/assets/ pdf_file/0009/170865/e96643.pdf 13

14 There are indications that some European countries did indeed reduce (e.g. Cyprus, Ireland, Lithuania, Portugal, Romania) or freeze (e.g. United Kingdom, Slovenia) the salaries of health professionals, or reduce the rate of salary increase (e.g. Denmark). 28 Greece faced particularly significant reductions in its health workforce. 29 Other approaches to lowering salaries included substantial increases in public sector pension contributions and reductions in benefits, leading to a de facto pay cut (United Kingdom); cutting overtime and night shifts, and lengthening shifts that involve fewer staff and costs (Iceland); and making workers accept lower wages in order to keep their contracts (privately contracted housekeeping and IT support staff in Serbia). In the Czech Republic, physicians managed to resist cuts to their salaries through negotiation or protest. Meanwhile, Albania, which was largely insulated from the crisis, and Belarus and Ukraine continued to increase health worker salaries. 30 To achieve short-term savings by lowering overhead costs, some countries also reported closing, merging, centralizing or cutting staff in non-provider organizations such as the health ministry, public health agencies and, less frequently, health insurance funds (Bulgaria, Croatia, Czech Republic, Denmark, Greece, Iceland, Kyrgyzstan, Latvia, Lithuania, Moldova, Portugal, Romania, Scotland, Serbia, Slovakia, Spain, Tajikistan, Ukraine, United Kingdom). In a few countries, quite radical changes were implemented. 31 Wage imbalances between countries (depending on changes in wages in immigration countries compared to emigration countries) or within countries (if the private and public sector have different rates of pay) are therefore likely to change considerably and have the potential to increase health-worker brain drain. 32 Initial indications are already flowing in, from Italy for example, which has gone from being a country of arrival for foreign trained nurses in the early 2000s, to a country of departure for both Italian nurses and doctors seeking jobs abroad. 33 Similarly, almost 1000 doctors, most of them specialists, leave Hungary every year to live and work in another European country. 34 A range of non-financial tools can be put in place by Ministries of Health to provide a limited degree of assistance in retaining health workers who are facing salary reductions and wage freezes. These tools include clear job descriptions, professional standards and codes of conduct, the proper matching of skills to the tasks in hand, supervision, information and communication, infrastructure including equipment and supplies, life-long learning, team management and team working, and responsibility with accountability Marina Karanikolos et al., Financial crisis, austerity, and health in Europe, The Lancet, 27 March These included a 25% reduction in doctors contracted by the central social security fund, and a 25% reduction in physicians wages and fees by the end of Mladovsky P, Srivastava D, Cylus J, et al., Policy summary 5. Health policy responses to the financial crisis in Europe, World Health Organization (on behalf of the European Observatory on Health Systems and Policies), data/assets/ pdf_file/0009/170865/e96643.pdf 31 WHO Regional Office for Europe, Health, health systems and economic crisis in Europe. Impact and policy implications. Summary, World Health Organization, Marina Karanikolos et al., Financial crisis, austerity, and health in Europe, The Lancet, 27 March Manuela Perrone, Medici con la valigia: fuga dall Italia. Raccontateci la vostra storia, Il sole 24 ore, 17 July 2013, ilsole24ore.com/art/lavoro-e-professione/ /medici-italiani-valigia-fuga _prn.php Mladovsky P, Srivastava D, Cylus J, et al., Policy summary 5. Health policy responses to the financial crisis in Europe, World Health Organization (on behalf of the European Observatory on Health Systems and Policies), data/assets/ pdf_file/0009/170865/e96643.pdf 14

15 A broader range of strategies in particular changing the skills mix and task shifting arrangements 36 to reduce the unit cost of labour are also under consideration in many crisis-hit countries as an alternative or as a complement to salary cuts. 37 Due to the lack of evidence and analysis, however, it is difficult to assess the full range and effects of cost reduction strategies on health systems and health workforces imposed to date in response to the economic crisis. Nevertheless, research carried out by the European Observatory on Health Systems and Policies has found that the pressure to achieve short-term savings was apparently greater than the desire to attain long-term equity and efficiency. Despite the fact that the crisis offers the opportunity to address waste in the health system, to cut wisely, to invest carefully, and to engage in structural reform in countries where this is needed, the survey indicates that cuts had been made in many cases across the board : clearly, it was often easier to increase user charges than to streamline the benefits package, and to cut health workers salaries rather than service prices. 38 This approach can be seen in cuts to health worker salaries: in countries such as Greece and Romania, where health worker salaries were already low, there is a genuine risk of further reductions impacting severely on the workers concerned, who may consider migration abroad, and on patients, who may end up paying informally to supplement low wages. 39 However, access to a sufficient and competent health workforce, and through it to vital services, is determined not only by the response to the crisis within the health system, but also by a country s broader fiscal policy response, i.e. the extent to which it follows a path of austerity as opposed to a path of counter-cyclical spending. Greece, Spain and Portugal and Italy to a certain extent adopted strict fiscal austerity; their economies continue to recede and the strain on their health care systems is growing, with cuts restricting access to health care. By contrast, Iceland rejected austerity through a popular vote, and the financial crisis seems to have had few or no discernible effects on health This typically involved nurses and GPs taking on some of the work of specialists or nurses taking on some of the work of GPs. 37 Mladovsky P, Srivastava D, Cylus J, et al., Policy summary 5. Health policy responses to the financial crisis in Europe, World Health Organization (on behalf of the European Observatory on Health Systems and Policies), data/assets/pdf_file/0009/170865/e96643.pdf 38 WHO Regional Office for Europe, Report of the Oslo conference Health systems in times of global economic crisis: an update of the situation in the WHO European Region, April, 2013, data/assets/pdf_file/0007/190456/healthsystems-in-times-of-global-economic-crisis,-an-update-of-the-situation-in-the-who-european-region.pdf 39 WHO Regional Office for Europe, Health, health systems and economic crisis in Europe. Impact and policy implications. Summary, World Health Organization, Marina Karanikolos et al., Financial crisis, austerity, and health in Europe, The Lancet, 27 March

16 The WHO affirms that countries, which implemented counter-cyclical fiscal policy tend to be in a stronger position to deal with the impact of the financial crisis. 41 Research even indicates that investments in health can accelerate economic recovery. 42 If fiscal balance has to be restored in the medium term, this does not necessarily require cuts in health and social spending during the crisis, when the need for these services rises and when the need for solidarity and equity may grow. 43 On the contrary, any fiscal policy should explicitly take account of the impact on health: for this reason it would be wise to make health ministers an accountable part of the negotiations on macroeconomic policies and even on austerity measures at the national as well as the continental level. This is even more advisable if we consider that the likely scenario is one of increasing international scrutiny of health budgets and a risk of restriction of fiscal space for health: countries bailed out by the troika in 2010 and 2011 are facing the kind of detailed international involvement in their health systems that has more normally been seen only in developing countries. 44 In addition, the EU is moving towards a new treaty that will further reinforce European monitoring of national budgets, 45 together with a new package of legal rules that provides for financial sanctions on countries that do not keep their budget deficits below 3% of GDP and government debt below 60% of GDP. 46 This will affect not just countries seeking bailouts; nearly the whole European Union will be compelled to further reduce public expenditure, as only four countries currently meet those overall criteria. 47 Health and the health workforce will therefore inevitably become central to discussions about public expenditure, since health systems and workforces account for so much spending that they cannot be ignored. Across the EU, health is typically the largest area of government expenditure after social protection. 48 In addition, health is under particular pressure because it is the area of public expenditure that is seen as having the greatest potential for improved productivity: the wide variations that exist within and between European countries in terms of cost and outcomes of health systems suggest a scope for substantial efficiency gains. This is less the case with social protection issues such as pensions, for which entitlements are defined World Health Organization, Regional Committee for Europe, health-systems-financing/activities/impact-of-the-financial-crisis-on-health-and-health-systems 42 David Stuckler, Sanjay Basu, The Body Economic. Why Austerity Kills, Basic Books, WHO Regional Office for Europe, Report of the Oslo conference Health systems in times of global economic crisis: an update of the situation in the WHO European Region, April, 2013, data/assets/pdf_file/0007/190456/healthsystems-in-times-of-global-economic-crisis,-an-update-of-the-situation-in-the-who-european-region.pdf 44 Fahy N. Who is shaping the future of European health systems?. BMJ 2012; 344: e1712. In Greece, for example, the troika has capped public spending on health, demanding that it should not exceed 6% of GDP, setting a precedent of control by the European Union over national health systems in individual countries. 45 European Council. Treaty on stability, coordination and governance in the economic and monetary union, European Commission. EU economic governance six-pack enters into force. MEMO/11/898, 12 Dec pressreleasesaction.do?reference=memo/11/ Fahy N. Who is shaping the future of European health systems?. BMJ, 2012; 344: e ibedem 49 ibedem 16

17 Overall, therefore, the capacity for Europe and its individual member states to provide a sustainable health workforce in times of crisis is closely linked to the much more political issue of their capacity to claim fiscal space for health both in national and in regional negotiations, as a condition of advancement along the path of Universal Health Coverage. Resources are, of course, limited and tough political choices on priorities therefore need to be made. The tools available to enlarge this fiscal space must also be sharpened: more progressive national taxation and the means to combat capital flight 50 and tax evasion (in Italy, for example, the problem of tax evasion is thought to equate to 17.4 % of the country s GDP), together with reduced defence budgets, can all free up considerable resources to fund health services across the continent and provide the resources to train and pay for sustainable health workforces. These same imbalances undermined the development of health systems and social services in low income countries: between 1970 and 2004 capital worth 600 billion US dollars was withdrawn from forty Sub-Saharan African countries, almost three times the level of public debt of the same countries. 51 The discussion about fiscal space and social justice must therefore be integrated in the public discourse on the right to health, to a sustainable workforce, and the brain drain from the European continent and at a global level. Recommendations Countries that have implemented counter-cyclical fiscal policy tend to be in a stronger position to deal with the impact of the financial crisis both from an economic and from a public health perspective. Austerity policies implying cuts in health and social spending during the crisis may therefore be counterproductive at a point when the need for these services rises and the need for solidarity and equity may grow. 52 Any fiscal policy should explicitly take account of health impact. Health ministers should be made an accountable part of negotiations on macroeconomic policies and austerity measures. As such, they should acquire the authority to claim fiscal space for health both in national and in regional level negotiations. The crisis may offer the opportunity to engage in structural health system reform in countries where this is needed. However, cost-effective public health and primary health care services need always to be protected in the event of budget cuts. The discussion about fiscal space and social justice must be integrated in the public discourse on the right to health, to a sustainable workforce and on the brain drain from the European continent and at a global level. 50 Tax havens are home to between 21 to 32 trillion US dollars, which are therefore subtracted to national taxation, see 51 Tax Justice Network, Magnitudes: Dirty Money, Lost Taxes and offshore, 2012, php?idcat= WHO Regional Office for Europe, Report of the Oslo conference Health systems in times of global economic crisis: an update of the situation in the WHO European Region, April, 2013, data/assets/pdf_file/0007/190456/healthsystems-in-times-of-global-economic-crisis,-an-update-of-the-situation-in-the-who-european-region.pdf 17

18 CHAPTER 3 IS THE HEALTH WORKFORCE A TRADABLE COMMODITY? by Monica Di Sisto, AMREF Italy and Remco van de Pas, Wemos Foundation There is a direct link between the international trading regime and the enjoyment of human rights. As the United Nations High Commission for Human Rights states, economic growth does not automatically lead to greater promotion and protection of human rights. 53 Speaking at the 2010 WTO Public Policy Forum, Ms Navanethem Pillay, the UN High Commissioner for Human Rights, stressed that it is true that human rights are predicated on the equality of all human beings, while the imperative of comparative advantage in trade inevitably creates winners and losers. And it is true that human rights priorities lie in the protection and empowerment of the vulnerable and the marginalized, while success in trade rewards those who possess a competitive edge in navigating the global markets. Further, human rights law insists on State obligations, while the liberalization of trade may make the role of States progressively shrink. Trade rules established within and outside the framework of the World Trade Organization (WTO) Agreement and the macroeconomic policies of international financial institutions do in fact have a particularly strong influence on shaping global society. Health care deserves special attention in trade policies, not only because it is a basic human right and has an important role in development but also because it is prone to market failure. 54 In theory, markets produce the goods and services we want in the right quantities and at the lowest possible cost. This is why markets are so powerful. But in the real world markets do not always work in the way theory predicts. This requires a stringent set of conditions perfect information, an abundance of buyers and sellers, a uniform product and freedom of entry and exit all of which ensure that firms are price takers, producing for the lowest possible cost in the long run and only earning normal profits. If producers do not operate in this way and, in particular, if they have a significant power to influence price or the total quantity being produced, then the market will fail. Suppliers of health care often have this power. If reliable evidence confirms that a particular trade policy has a negative impact on the enjoyment of the right to health of those living in poverty or of other disadvantaged groups, then the State has an obligation under international human rights law to revise the relevant policy. It is thus imperative that, at the very least, trade and economic policies should do no harm to health. When negotiating trade agreements, special attention must therefore be paid to their potential impact on health, particularly on population health, on the risks to health, on the resources available for health and on universal access to health services. All trade agreements should 53 Statement by Ms Navanethem Pillay, United Nations High Commissioner for Human Rights to the WTO Public Policy Forum, Doing it Differently: Reshaping the Global Economy, Geneva, 16 September Ronald Labonté et al, Globalization and Health Equity: Innovation for an Interconnected World, Based upon: Towards Health- Equitable Globalization: Rights, Regulation and Redistribution. Final Report to the Commission on Social Determinants of Health. Available at: GFHR%2011.pdf 18

19 be subject to an assessment of health impacts, and should be publicly debated before signing. In this chapter, we intend to discuss some of the more contentious aspects of the debate on trade in services as it relates to the movements of health personnel. Are services tradable? Trade in services was included as an issue for multilateral trade negotiations in the Punta Del Este Ministerial Declaration, which launched the Uruguay Round Negotiations under the WTO umbrella in September These negotiations were preceded by a long and controversial debate on the tradability of services and hence on its relevance as a subject for multilateral trade negotiations. The General Agreement on Trade in Services (GATS), which came into force in 1995 between the members of the World Trade Organization, is the first agreement on principles and rules for trade in services. The GATS negotiations are therefore ongoing as a part of the Doha Development Round. In 2008, negotiations had once again been suspended and it was unclear if and when the outcome in this round would be reached. Following the release of results in the recent WTO ministerial conference in Bali in 2013, it is expected that negotiations will resume as soon as possible in Geneva. It is this prospect that has motivated us to take the trade in services at the centre of our analysis. The international trade in services International trade in services is defined by the Four Modes of Supply of the General Agreement on Trade in Services (GATS) negotiated within the framework of the WTO. If we follow the WHO s 55 suggestions in declining the commercial aspects of health services, we will find that: (Mode 1) Cross-border trade - is defined as health services provided from the territory of one member state in the territory of another member state. This usually takes place via interactive audio, visual and data communication. Typical examples include Internet consultation, diagnosis, treatment and medical education. (Mode 2) Consumption abroad - this mode covers supply of a service from one country to the service consumer of any other country. It usually covers incidents when patients seek treatment abroad or when people abroad find themselves in need of treatment. It can generate foreign exchange, but it can equally crowd out local patients and act as a drain on resources when their treatment is subsidized by the sending government. (Mode 3) Commercial presence which covers health services supplied in one member state, through a commercial presence in the territory of another member state. This covers the opening up of the health sector to foreign companies, allowing them to invest in health operations, health management and health insurance. (Mode 4) Presence of natural persons this is the temporary movement of a commercial provider of services (for example, a doctor or a nurse) from their own country to another country to provide his or her services under contract or as a member of staff transferred to a different country. This is one of the most contentious areas for health, as there is concern that it will increase the brain drain of health personnel from poor to rich countries. However, GATS is concerned only with health professionals working in other countries on a temporary basis

20 The EU25 is by far the world s largest exporter and importer of services. 56 The share of services in cross-border trade has been increasing faster than the trade in goods. This trend has been driven by a number of factors, including technological change, commercialization and liberalization, and accelerated by the increased reliance on China and other low-wage countries to supply the need for manufactured goods. Tertiarization (development of the service sector) has given rise to a wide range of controversial issues, from job quality to the appropriateness of existing structures of social regulation, social insurance and also collective interest representation. GATS guarantees foreign service providers access to markets under stable conditions; in theory, the countries will gain in terms of output and employment, growth in services and cheaper and better quality services, thereby generating positive welfare effects on the economy as a whole. On the other hand, critics consisting of parts of the labour movement, civil society organizations, some academics and some national governments emphasize the threats to national sovereignty and negative consequences for equity and social development. Critics also fear that the new rounds of services negotiations will force WTO members to open all services sectors to foreign competition, including public services. The threats from GATS are seen as particularly serious since GATS commitments are irreversible. GATS threatens to seriously undermine any public health care service that has not been privatized, based on the claim that the government should not offer subsidized services that the market also offers. 57 An opt-out alternative exists in theory, but developing countries, lacking market power and the resources to hire highly skilled negotiators and experts to defend their national interests in multilateral negotiations, are unlikely to be in a strong enough bargaining position to hold firm to such an alternative through successive rounds of negotiation. Movement of natural persons Under GATS, the fourth mode of service supply or presence of natural persons does not apply to persons seeking access to the employment market in the host country, nor does it affect measures regarding citizenship, residence or employment on a permanent basis. The Agreement does not prevent a member from taking measures to regulate the entry of natural persons into, or their temporary stay in, its territory, including those measures necessary to protect the integrity of, and to ensure the orderly movement of natural persons across its borders. Mode 4 of GATS, in relation to the trade in health services, focuses particularly on the provision of health services by individuals from another country on a temporary basis. The possible impact of GATS on health care is controversial. In terms of migration, some countries may benefit from the fact that agreeing to send their health workers abroad will reduce unemployment at home, but GATS, like all WTO agreements, requires reciprocity. All countries have the opportunity to negotiate agreements, so this measure does not automatically translate into a unique advantage for the proposer. For example, other WTO members are entitled to ask the same country for equal access to health services for their own professionals, in effect cancelling out the impact of the original measure. Early indications suggest that countries are more likely to enter into agreements for the modes that govern the supply of services and commercial presence (Modes 1 3), such as private hospitals and clinics and a range of other commercial health-related facilities, than they are to 56 The EU25 accounts for 27% of global exports and 24.4% of imports, almost double the respective figures for the USA (14.7% and 12%). Japan and China follow at a considerable distance. Gintare Kemekliene and Andrew Watt, GATS and the EU: impacts on labour markets and regulatory capacity, European trade union institute, Missoni E. Understanding the impact of global trade liberalization on health systems pursuing universal health coverage. Value Health, 2013 Jan-Feb;16(1 Suppl):S14-8. doi: /j.jval Epub 2012 Nov

COMMISSION STAFF WORKING DOCUMENT. on an Action Plan for the EU Health Workforce. Accompanying the document

COMMISSION STAFF WORKING DOCUMENT. on an Action Plan for the EU Health Workforce. Accompanying the document EUROPEAN COMMISSION Strasbourg, 18.4.2012 SWD(2012) 93 final COMMISSION STAFF WORKING DOCUMENT on an Action Plan for the EU Health Workforce Accompanying the document COMMUNICATION FROM THE COMMISSION

More information

The Helsinki Communiqué

The Helsinki Communiqué The Helsinki Communiqué on Enhanced European Cooperation in Vocational Education and Training Communiqué of the European Ministers of Vocational Education and Training 1, the European Social partners 2

More information

PORTABILITY OF SOCIAL SECURITY AND HEALTH CARE BENEFITS IN ITALY

PORTABILITY OF SOCIAL SECURITY AND HEALTH CARE BENEFITS IN ITALY PORTABILITY OF SOCIAL SECURITY AND HEALTH CARE BENEFITS IN ITALY Johanna Avato Human Development Network Social Protection and Labor The World Bank Background study March 2008 The Italian Social Security

More information

EUROPE 2020 TARGET: TERTIARY EDUCATION ATTAINMENT

EUROPE 2020 TARGET: TERTIARY EDUCATION ATTAINMENT EUROPE 2020 TARGET: TERTIARY EDUCATION ATTAINMENT Low tertiary or equivalent education attainment levels create skills bottlenecks in knowledgeintensive economic sectors and hamper productivity, innovation

More information

IMMIGRATION TO AND EMIGRATION FROM GERMANY IN THE LAST FEW YEARS

IMMIGRATION TO AND EMIGRATION FROM GERMANY IN THE LAST FEW YEARS IMMIGRATION TO AND EMIGRATION FROM GERMANY IN THE LAST FEW YEARS Bernd Geiss* Germany, Destination for Migrants Germany is in the middle of Europe and has common borders with nine countries. Therefore,

More information

UNITED NATIONS INDEPENDENT EXPERT ON THE QUESTION OF HUMAN RIGHTS AND EXTREME POVERTY

UNITED NATIONS INDEPENDENT EXPERT ON THE QUESTION OF HUMAN RIGHTS AND EXTREME POVERTY UNITED NATIONS INDEPENDENT EXPERT ON THE QUESTION OF HUMAN RIGHTS AND EXTREME POVERTY Questionnaire JAN/2011 Post-crisis adjustment and fiscal consolidation processes (2010 onwards) 1. Has your country

More information

TO ASSET AFTER FISCAL

TO ASSET AFTER FISCAL PUBLIC SERVICE: FROM COST TO ASSET AFTER FISCAL CONSOLIDATION Mario Marcel, Deputy Director Public Governance and Territorial Development, OECD Lisbon 24 January 2014 Contents Changes in the fiscal environment

More information

Research Briefing. The Best and the Brightest EU students at UK universities and as highly skilled graduate workers in the UK

Research Briefing. The Best and the Brightest EU students at UK universities and as highly skilled graduate workers in the UK Research Briefing The Best and the Brightest EU students at UK universities and as highly skilled graduate workers in the UK Academic performance and labour market outcomes of EU domiciled students in

More information

Small Scale Study ll. Managed Migration and the Labour Market the Health Sector

Small Scale Study ll. Managed Migration and the Labour Market the Health Sector 1 Small Scale Study ll Managed Migration and the Labour Market the Health Sector Swedish NCP 2 1. Executive summary...3 2. Introduction to the healthcare sector in Sweden...4 2.1 County councils' main

More information

EUROPE 2020 TARGETS: RESEARCH AND DEVELOPMENT

EUROPE 2020 TARGETS: RESEARCH AND DEVELOPMENT EUROPE 2020 TARGETS: RESEARCH AND DEVELOPMENT Research, development and innovation are key policy components of the EU strategy for economic growth: Europe 2020. By fostering market take-up of new, innovative

More information

Swiss Contributions to Human Resources for Health Development in Low- and Middle- Income Countries

Swiss Contributions to Human Resources for Health Development in Low- and Middle- Income Countries Swiss Contributions to Human Resources for Health Development in Low- and Middle- Income Countries Swiss TPH / SCIH Swiss Contributions to HRH Development in Low- and Middle- Income Countries Editorial

More information

Declaration of the Ministerial Conference of the Khartoum Process

Declaration of the Ministerial Conference of the Khartoum Process Declaration of the Ministerial Conference of the Khartoum Process (EU-Horn of Africa Migration Route Initiative) Rome, 28 th November 2014 We, Ministers of the following countries: Austria, Belgium, Bulgaria,

More information

REPORT FROM THE COMMISSION TO THE COUNCIL. on the Functioning of the Transitional Arrangements on Free Movement of Workers from Bulgaria and Romania

REPORT FROM THE COMMISSION TO THE COUNCIL. on the Functioning of the Transitional Arrangements on Free Movement of Workers from Bulgaria and Romania EUROPEAN COMMISSION Brussels, 11.11.2011 COM(2011) 729 final REPORT FROM THE COMMISSION TO THE COUNCIL on the Functioning of the Transitional Arrangements on Free Movement of Workers from Bulgaria and

More information

Definition of Public Interest Entities (PIEs) in Europe

Definition of Public Interest Entities (PIEs) in Europe Definition of Public Interest Entities (PIEs) in Europe FEE Survey October 2014 This document has been prepared by FEE to the best of its knowledge and ability to ensure that it is accurate and complete.

More information

Statistical Data on Women Entrepreneurs in Europe

Statistical Data on Women Entrepreneurs in Europe Statistical Data on Women Entrepreneurs in Europe September 2014 Enterprise and Industry EUROPEAN COMMISSION Directorate-General for Enterprise and Industry Directorate D SMEs and Entrepreneurship Unit

More information

A European Unemployment Insurance Scheme

A European Unemployment Insurance Scheme A European Unemployment Insurance Scheme Necessary? Desirable? Optimal? Grégory Claeys, Research Fellow, Bruegel Zsolt Darvas, Senior Fellow, Bruegel Guntram Wolff, Director, Bruegel July, 2014 Key messages

More information

International Monetary and Financial Committee

International Monetary and Financial Committee International Monetary and Financial Committee Twenty-Seventh Meeting April 20, 2013 Statement by Koen Geens, Minister of Finance, Ministere des Finances, Belgium On behalf of Armenia, Belgium, Bosnia

More information

COMMUNICATION FROM THE COMMISSION

COMMUNICATION FROM THE COMMISSION EUROPEAN COMMISSION Brussels, 17.9.2014 C(2014) 6767 final COMMUNICATION FROM THE COMMISSION Updating of data used to calculate lump sum and penalty payments to be proposed by the Commission to the Court

More information

Private health insurance: second-best or second-worst solution? Sarah Thomson EHMA VHI MASTERCLASS Milan, 27 June 2013

Private health insurance: second-best or second-worst solution? Sarah Thomson EHMA VHI MASTERCLASS Milan, 27 June 2013 Private health insurance: second-best or second-worst solution? Sarah Thomson EHMA VHI MASTERCLASS Milan, 27 June 2013 VHI as a policy tool Policy goals Research findings Policy design Regulation Over

More information

Recommendation for a COUNCIL RECOMMENDATION. on Poland s 2014 national reform programme

Recommendation for a COUNCIL RECOMMENDATION. on Poland s 2014 national reform programme EUROPEAN COMMISSION Brussels, 2.6.2014 COM(2014) 422 final Recommendation for a COUNCIL RECOMMENDATION on Poland s 2014 national reform programme and delivering a Council opinion on Poland s 2014 convergence

More information

The Borderless Workforce 2011. Australia and New Zealand Research Results

The Borderless Workforce 2011. Australia and New Zealand Research Results The Borderless Workforce 2011 Australia and New Zealand Research Results Introduction Given the fact that neither Australia or New Zealand are facing problems, like high unemployment rates during the labour

More information

Investment and Investment Finance in Croatia, how can the EIB contribute? Dario Scannapieco and Debora Revoltella European Investment Bank

Investment and Investment Finance in Croatia, how can the EIB contribute? Dario Scannapieco and Debora Revoltella European Investment Bank Investment and Investment Finance in Croatia, how can the EIB contribute? Dario Scannapieco and Debora Revoltella European Investment Bank 24 March 2014 Outline EU and Croatia key challenges The Investment

More information

Contract Work in Switzerland. A Brief Guide

Contract Work in Switzerland. A Brief Guide Contract Work in Switzerland. A Brief Guide Introduction to Swissroll There are approximately 1,000,000 foreign employees in Switzerland, 25% of which commute from outside the country. Swissroll are registered

More information

THE ORGANISATION AND FINANCING OF HEALTH CARE SYSTEM IN LATVIA

THE ORGANISATION AND FINANCING OF HEALTH CARE SYSTEM IN LATVIA THE ORGANISATION AND FINANCING OF HEALTH CARE SYSTEM IN LATVIA Eriks Mikitis Ministry of Health of the Republic of Latvia Department of Health Care Director General facts, financial resources Ministry

More information

Project PESSIS 2 Title: Social Dialogue in the Social Services Sector in Europe

Project PESSIS 2 Title: Social Dialogue in the Social Services Sector in Europe Project PESSIS 2 Title: Social Dialogue in the Social Services Sector in Europe Location Brussels Date 23 September 2014 Presenter/contact details: Jane Lethbridge, Director, Public Services International

More information

EUROPE 2020 TARGET: EARLY LEAVERS FROM EDUCATION AND TRAINING

EUROPE 2020 TARGET: EARLY LEAVERS FROM EDUCATION AND TRAINING EUROPE 2020 TARGET: EARLY LEAVERS FROM EDUCATION AND TRAINING By 2020, the share of early leavers from education and training (aged 18-24) should be less than 10% Early school leaving 1 is an obstacle

More information

PREREQUISITES FOR HEALTH

PREREQUISITES FOR HEALTH Charter The first International Conference on Health Promotion, meeting in Ottawa this 21 st day of November 1986, hereby presents this CHARTER for action to achieve Health for All by the year 2000 and

More information

Attribution 4.0 International (CC BY 4.0) This presentation is licensed under a Creative Commons Attribution 4.0 International license.

Attribution 4.0 International (CC BY 4.0) This presentation is licensed under a Creative Commons Attribution 4.0 International license. Attribution 4.0 International (CC BY 4.0) This presentation is licensed under a Creative Commons Attribution 4.0 International license. Therefor you are free to share and adapt this presentation even for

More information

COUNCIL OF THE EUROPEAN UNION. Brussels, 2 May 2011 9564/11. Interinstitutional File: 2010/0210 (COD)

COUNCIL OF THE EUROPEAN UNION. Brussels, 2 May 2011 9564/11. Interinstitutional File: 2010/0210 (COD) COUNCIL OF THE EUROPEAN UNION Brussels, 2 May 2011 Interinstitutional File: 2010/0210 (COD) 9564/11 SOC 372 MIGR 99 CODEC 714 DRS 64 WTO 187 SERVICES 66 NOTE from: Council General Secretariat to: Delegations

More information

EU s Asylum Policy and the Danish Justice and Home Affairs Opt-Out

EU s Asylum Policy and the Danish Justice and Home Affairs Opt-Out EU s Asylum Policy and the Danish Justice and Home Affairs Opt-Out Marlene Wind, Professor and Director of Centre for European Politics, Department of Political Science, University of Copenhagen Professor

More information

INTRODUCTION... 2. I. Participation in the 2014 European elections... 3

INTRODUCTION... 2. I. Participation in the 2014 European elections... 3 ?? Directorate-General for Communication PUBLIC OPINION MONITORING UNIT 2014 EUROPEAN ELECTIONS DESK RESEARCH Brussels, April 2015 Profile of voters and abstainees in the European elections 2014 INTRODUCTION...

More information

PORTABILITY OF SOCIAL SECURITY AND HEALTH CARE BENEFITS IN THE UNITED KINGDOM

PORTABILITY OF SOCIAL SECURITY AND HEALTH CARE BENEFITS IN THE UNITED KINGDOM PORTABILITY OF SOCIAL SECURITY AND HEALTH CARE BENEFITS IN THE UNITED KINGDOM Johanna Avato Human Development Network Social Protection and Labor The World Bank Background study March 2008 The UK Social

More information

How can the migration of health service professionals be managed so as to reduce any negative effects on supply?

How can the migration of health service professionals be managed so as to reduce any negative effects on supply? HEALTH SYSTEMS AND POLICY ANALYSIS POLICY BRIEF How can the migration of health service professionals be managed so as to reduce any negative effects on supply? James Buchan Keywords: HEALTH PERSONNEL

More information

Global Support to Develop Domestic Bond Markets in Emerging Market Economies and Developing Countries The Italian Experience.

Global Support to Develop Domestic Bond Markets in Emerging Market Economies and Developing Countries The Italian Experience. Global Support to Develop Domestic Bond Markets in Emerging Market Economies and Developing Countries The Italian Experience. 22/23 September 2008 Frankfurt am Main Pierpaolo Battista Italian Ministry

More information

Narrowing the Sustainability Gap of EU and US Health Care Spending

Narrowing the Sustainability Gap of EU and US Health Care Spending Working Paper Research Division EU Integration Stiftung Wissenschaft und Politik German Institute for International and Security Affairs Amy Medearis, Ognian N. Hishow 1 Narrowing the Sustainability Gap

More information

Problem analysis: why the EU Battlegroups have not been used so far. Four factors hampering the deployability of the Battlegroups can be identified:

Problem analysis: why the EU Battlegroups have not been used so far. Four factors hampering the deployability of the Battlegroups can be identified: DISCUSSION PAPER (16 JULY 2014) EU BATTLEGROUPS: USE THEM OR LOSE THEM SUBMITTED BY THE DELEGATION OF THE NETHERLANDS TO THE ITALIAN PRESIDENCY PARLIAMENT OF THE IPC CFSP/CSDP Introduction At the European

More information

European judicial training 2014. Justice

European judicial training 2014. Justice European judicial training 2014 Justice Europe Direct is a service to help you find answers to your questions about the European Union. Freephone number (*): 00 800 6 7 8 9 10 11 (*) Certain mobile telephone

More information

Monitoring the social impact of the crisis: public perceptions in the European Union (wave 6) REPORT

Monitoring the social impact of the crisis: public perceptions in the European Union (wave 6) REPORT Eurobarometer Monitoring the social impact of the crisis: public perceptions in the European Union (wave 6) REPORT Fieldwork: December 2011 Publication: April 2012 This survey has been requested by Directorate-General

More information

The European Commission s strategy on Corporate Social Responsibility (CSR) 2011-2014: achievements, shortcomings and future challenges

The European Commission s strategy on Corporate Social Responsibility (CSR) 2011-2014: achievements, shortcomings and future challenges The European Commission s strategy on Corporate Social Responsibility (CSR) 2011-2014: achievements, shortcomings and future challenges Fields marked with are mandatory. 1 Introduction - Background and

More information

EXECUTIVE SUMMARY. Measuring money laundering at continental level: The first steps towards a European ambition. January 2011 EUROPEAN COMMISSION

EXECUTIVE SUMMARY. Measuring money laundering at continental level: The first steps towards a European ambition. January 2011 EUROPEAN COMMISSION MONEY LAUNDERING IN EUROPE Measuring money laundering at continental level: The first steps towards a European ambition EXECUTIVE SUMMARY January 2011 EUROPEAN COMMISSION DG HOME AFFAIRS FIGHT AGAINST

More information

RETAIL FINANCIAL SERVICES

RETAIL FINANCIAL SERVICES Special Eurobarometer 373 RETAIL FINANCIAL SERVICES REPORT Fieldwork: September 211 Publication: April 212 This survey has been requested by the European Commission, Directorate-General Internal Market

More information

RETAIL FINANCIAL SERVICES

RETAIL FINANCIAL SERVICES Special Eurobarometer 373 RETAIL FINANCIAL SERVICES REPORT Fieldwork: September 211 Publication: March 212 This survey has been requested by Directorate-General Internal Market and Services and co-ordinated

More information

Finland must take a leap towards new innovations

Finland must take a leap towards new innovations Finland must take a leap towards new innovations Innovation Policy Guidelines up to 2015 Summary Finland must take a leap towards new innovations Innovation Policy Guidelines up to 2015 Summary 3 Foreword

More information

The State of Oral Health in Europe. Professor Kenneth Eaton Chair of the Platform for Better Oral Health in Europe

The State of Oral Health in Europe. Professor Kenneth Eaton Chair of the Platform for Better Oral Health in Europe The State of Oral Health in Europe Professor Kenneth Eaton Chair of the Platform for Better Oral Health in Europe 1 TOPICS TO BE COVERED What is the Platform? Its aims and work The report (State of Oral

More information

MAPPING THE IMPLEMENTATION OF POLICY FOR INCLUSIVE EDUCATION

MAPPING THE IMPLEMENTATION OF POLICY FOR INCLUSIVE EDUCATION MAPPING THE IMPLEMENTATION OF POLICY FOR INCLUSIVE EDUCATION MAPPING THE IMPLEMENTATION OF POLICY FOR INCLUSIVE EDUCATION (MIPIE) An exploration of challenges and opportunities for developing indicators

More information

Ownership transfer Critical Tax Issues. Johan Fall, Anders Ydstedt March, 2010

Ownership transfer Critical Tax Issues. Johan Fall, Anders Ydstedt March, 2010 Ownership transfer Critical Tax Issues Johan Fall, Anders Ydstedt March, 2010 Ownership transfer Critical Tax Issues 1 Ownership transfer Critical Tax Issues INTRODUCTION In tough economic times family

More information

ARE THE POINTS OF SINGLE CONTACT TRULY MAKING THINGS EASIER FOR EUROPEAN COMPANIES?

ARE THE POINTS OF SINGLE CONTACT TRULY MAKING THINGS EASIER FOR EUROPEAN COMPANIES? ARE THE POINTS OF SINGLE CONTACT TRULY MAKING THINGS EASIER FOR EUROPEAN COMPANIES? SERVICES DIRECTIVE IMPLEMENTATION REPORT NOVEMBER 2011 EUROPEAN COMPANIES WANT WELL-FUNCTIONING POINTS OF SINGLE CONTACT

More information

Internal Market: Awareness, Perceptions and Impacts

Internal Market: Awareness, Perceptions and Impacts Special Eurobarometer 363 European Commission Internal Market: Awareness, Perceptions and Impacts REPORT Special Eurobarometer 363 / Wave TNS opinion & social Fieldwork: February-March 2011 Publication:

More information

A proposal for measures under Norwegian foreign and international development policy to combat the global health workforce crisis

A proposal for measures under Norwegian foreign and international development policy to combat the global health workforce crisis A proposal for measures under Norwegian foreign and international development policy to combat the global health workforce crisis Report by the workgroup headed by the Ministry of Foreign Affairs, with

More information

SWECARE FOUNDATION. Uniting the Swedish health care sector for increased international competitiveness

SWECARE FOUNDATION. Uniting the Swedish health care sector for increased international competitiveness SWECARE FOUNDATION Uniting the Swedish health care sector for increased international competitiveness SWEDEN IN BRIEF Population: approx. 9 800 000 (2015) GDP/capita: approx. EUR 43 300 (2015) Unemployment

More information

Size and Development of the Shadow Economy of 31 European and 5 other OECD Countries from 2003 to 2015: Different Developments

Size and Development of the Shadow Economy of 31 European and 5 other OECD Countries from 2003 to 2015: Different Developments January 20, 2015 ShadEcEurope31_January2015.doc Size and Development of the Shadow Economy of 31 European and 5 other OECD Countries from 2003 to 2015: Different Developments by Friedrich Schneider *)

More information

The Tax Burden of Typical Workers in the EU 27 2013 Edition

The Tax Burden of Typical Workers in the EU 27 2013 Edition (Cover page) The Tax Burden of Typical Workers in the EU 27 2013 Edition James Rogers & Cécile Philippe May 2013 Data provided by NEW DIRECTION Page 1 of 16 The Tax Burden of Typical Workers in the EU

More information

Minimum Wage Protection Current German and European Debates

Minimum Wage Protection Current German and European Debates Årskonferanse i Fafo Østforum Fire år etter EU-utvidelsen: Status og framtidsperspektiver Oslo, 3 June 2008 Minimum Wage Protection Current German and European Debates Thorsten Schulten Wirtschafts- und

More information

2014 post-election survey EUROPEAN ELECTIONS 2014

2014 post-election survey EUROPEAN ELECTIONS 2014 Directorate-General for Communication PUBLIC OPINION MONITORING UNIT Brussels, October 2014. 2014 post-election survey EUROPEAN ELECTIONS 2014 ANALYTICAL OVERVIEW Coverage: Population: Methodology: Fieldwork:

More information

How many students study abroad and where do they go?

How many students study abroad and where do they go? From: Education at a Glance 2012 Highlights Access the complete publication at: http://dx.doi.org/10.1787/eag_highlights-2012-en How many students study abroad and where do they go? Please cite this chapter

More information

CABINET OFFICE THE CIVIL SERVICE NATIONALITY RULES

CABINET OFFICE THE CIVIL SERVICE NATIONALITY RULES ANNEX A CABINET OFFICE THE CIVIL SERVICE NATIONALITY RULES Introduction The Civil Service Nationality Rules concern eligibility for employment in the Civil Service on the grounds of nationality and must

More information

Global Leaders' Meeting on Gender Equality and Women's Empowerment: A Commitment to Action 27 September 2015, New York

Global Leaders' Meeting on Gender Equality and Women's Empowerment: A Commitment to Action 27 September 2015, New York Global Leaders' Meeting on Gender Equality and Women's Empowerment: A Commitment to Action 27 September 2015, New York EU and its Member States' Commitments to the full, effective and accelerated implementation

More information

The EMU and the debt crisis

The EMU and the debt crisis The EMU and the debt crisis MONETARY POLICY REPORT FEBRUARY 212 43 The debt crisis in Europe is not only of concern to the individual debt-ridden countries; it has also developed into a crisis for the

More information

Quality in and Equality of Access to Healthcare Services

Quality in and Equality of Access to Healthcare Services Quality in and Equality of Access to Healthcare Services Executive Summary European Commission Directorate-General for Employment, Social Affairs and Equal Opportunities Manuscript completed in March 2008

More information

SMEs access to finance survey 2014

SMEs access to finance survey 2014 EUROPEAN COMMISSION MEMO Brussels, 12 November 2014 SMEs access to finance survey 2014 This memo outlines the results of a survey undertaken by the European Commission to provide policy makers with evidence

More information

European Defense Trends

European Defense Trends European Defense Trends Budgets, Regulatory Frameworks, and the Industrial Base An Annotated Brief CSIS Defense-Industrial Initiatives Group project directors Guy Ben-Ari David Berteau authors Joachim

More information

WOMEN IN DECISION-MAKING POSITIONS

WOMEN IN DECISION-MAKING POSITIONS Special Eurobarometer 376 WOMEN IN DECISION-MAKING POSITIONS REPORT Fieldwork: September 2011 Publication: March 2012 This survey has been requested by Directorate-General Justice and co-ordinated by Directorate-

More information

Labour Market, Social Policy, Social Security System and Migration Policy - Current State and Problems Which Bulgaria Faces

Labour Market, Social Policy, Social Security System and Migration Policy - Current State and Problems Which Bulgaria Faces Labour Market, Social Policy, Social Security System and Migration Policy - Current State and Problems Which Bulgaria Faces February 21, 2003, Bratislava I. Labour market- current state, problems and undertaken

More information

MALTA TRADING COMPANIES IN MALTA

MALTA TRADING COMPANIES IN MALTA MALTA TRADING COMPANIES IN MALTA Trading companies in Malta 1. An effective jurisdiction for international trading operations 410.000 MALTA GMT +1 Located in the heart of the Mediterranean, Malta has always

More information

PUBLIC DEBT SIZE, COST AND LONG-TERM SUSTAINABILITY: PORTUGAL VS. EURO AREA PEERS

PUBLIC DEBT SIZE, COST AND LONG-TERM SUSTAINABILITY: PORTUGAL VS. EURO AREA PEERS PUBLIC DEBT SIZE, COST AND LONG-TERM SUSTAINABILITY: PORTUGAL VS. EURO AREA PEERS 1. Introduction This note discusses the strength of government finances in, and its relative position with respect to other

More information

Evolution of informal employment in the Dominican Republic

Evolution of informal employment in the Dominican Republic NOTES O N FORMALIZATION Evolution of informal employment in the Dominican Republic According to official estimates, between 2005 and 2010, informal employment fell from 58,6% to 47,9% as a proportion of

More information

Will Bulgaria Remain a "Quiet Place" for Higher Education?

Will Bulgaria Remain a Quiet Place for Higher Education? Page 1 of 5 Will Bulgaria Remain a "Quiet Place" for Higher Education? Bulgarian higher education fails to compete successfully either within the EU or with the US. It is lagging behind in terms of available

More information

REPORT FROM THE COMMISSION TO THE EUROPEAN PARLIAMENT AND THE COUNCIL

REPORT FROM THE COMMISSION TO THE EUROPEAN PARLIAMENT AND THE COUNCIL EUROPEAN COMMISSION Brussels, 25.9.2014 COM(2014) 592 final REPORT FROM THE COMMISSION TO THE EUROPEAN PARLIAMENT AND THE COUNCIL on the implementation in the period from 4 December 2011 until 31 December

More information

RIA: Benefits and Application

RIA: Benefits and Application RIA: Benefits and Application Scott Jacobs Managing Director, Jacobs and Associates WORKSHOP ON GOOD REGULATORY PRACTICE WTO, Geneva 18-19 MARCH 2008 1 The Golden Age of Regulation Regulation is a normal

More information

Immigration Reform, Economic Growth, and the Fiscal Challenge Douglas Holtz- Eakin l April 2013

Immigration Reform, Economic Growth, and the Fiscal Challenge Douglas Holtz- Eakin l April 2013 Immigration Reform, Economic Growth, and the Fiscal Challenge Douglas Holtz- Eakin l April 2013 Executive Summary Immigration reform can raise population growth, labor force growth, and thus growth in

More information

EUROPEAN AREA OF SKILLS AND QUALIFICATIONS

EUROPEAN AREA OF SKILLS AND QUALIFICATIONS EUROPEAN AREA OF SKILLS AND QUALIFICATIONS REPORT Fieldwork: April - May 2014 Publication: June 2014 This survey has been requested by the European Commission, Directorate-General for Education and Culture

More information

ORGANISATION FOR ECONOMIC CO-OPERATION AND DEVELOPMENT

ORGANISATION FOR ECONOMIC CO-OPERATION AND DEVELOPMENT 2 OECD RECOMMENDATION OF THE COUNCIL ON THE PROTECTION OF CRITICAL INFORMATION INFRASTRUCTURES ORGANISATION FOR ECONOMIC CO-OPERATION AND DEVELOPMENT The OECD is a unique forum where the governments of

More information

G20 Labour and Employment Ministers Declaration Moscow, 18-19 July 2013

G20 Labour and Employment Ministers Declaration Moscow, 18-19 July 2013 G20 Labour and Employment Ministers Declaration Moscow, 18-19 July 2013 1. We, the Ministers of Labour and Employment from G20 countries met in Moscow on July 18-19, 2013 to discuss the global labour market

More information

Live Long and Prosper? Demographic Change and Europe s Pensions Crisis

Live Long and Prosper? Demographic Change and Europe s Pensions Crisis 10 November 2015, Brussels Live Long and Prosper? Demographic Change and Europe s Pensions Crisis Key Note Speech Dr. Jochen Pimpertz Head of Research Unit Public Finance, Social Security, Income and Wealth

More information

INNOVATION IN THE PUBLIC SECTOR: ITS PERCEPTION IN AND IMPACT ON BUSINESS

INNOVATION IN THE PUBLIC SECTOR: ITS PERCEPTION IN AND IMPACT ON BUSINESS Flash Eurobarometer INNOVATION IN THE PUBLIC SECTOR: ITS PERCEPTION IN AND IMPACT ON BUSINESS REPORT Fieldwork: February-March 22 Publication: June 22 This survey has been requested by the European Commission,

More information

BUILDING MIGRATION PARTNERSHIPS PRAGUE MINISTERIAL CONFERENCE JOINT DECLARATION

BUILDING MIGRATION PARTNERSHIPS PRAGUE MINISTERIAL CONFERENCE JOINT DECLARATION BUILDING MIGRATION PARTNERSHIPS PRAGUE MINISTERIAL CONFERENCE JOINT DECLARATION We, the Ministers responsible for migration and other representatives from: Albania, Armenia, Austria, Azerbaijan, Belgium,

More information

OUTCOME OF THE COUNCIL MEETING. 3375th Council meeting. Economic and Financial Affairs. Brussels, 10 March 2015. Minister for Finance of Latvia

OUTCOME OF THE COUNCIL MEETING. 3375th Council meeting. Economic and Financial Affairs. Brussels, 10 March 2015. Minister for Finance of Latvia Council of the European Union 7004/15 (OR. en) PROVISIONAL VERSION PRESSE 20 PR CO 12 OUTCOME OF THE COUNCIL MEETING 3375th Council meeting Economic and Financial Affairs Brussels, 10 March 2015 President

More information

WICARE - Surveying wages and working conditions in the Social Services

WICARE - Surveying wages and working conditions in the Social Services WICARE - Surveying wages and working conditions in the Social Services Social Services Workshop, EPSU Brussels, Belgium 17 December 2013 Kea Tijdens and Maarten van Klaveren (AIAS-UVA) Introduction Why

More information

INNOBAROMETER 2015 - THE INNOVATION TRENDS AT EU ENTERPRISES

INNOBAROMETER 2015 - THE INNOVATION TRENDS AT EU ENTERPRISES Eurobarometer INNOBAROMETER 2015 - THE INNOVATION TRENDS AT EU ENTERPRISES REPORT Fieldwork: February 2015 Publication: September 2015 This survey has been requested by the European Commission, Directorate-General

More information

Electricity, Gas and Water: The European Market Report 2014

Electricity, Gas and Water: The European Market Report 2014 Brochure More information from http://www.researchandmarkets.com/reports/2876228/ Electricity, Gas and Water: The European Market Report 2014 Description: The combined European annual demand for electricity,

More information

4/17/2015. Health Insurance. The Framework. The importance of health care. the role of government, and reasons for the costs increase

4/17/2015. Health Insurance. The Framework. The importance of health care. the role of government, and reasons for the costs increase Health Insurance PhD. Anto Bajo Faculty of Economics and Business, University of Zagreb The Framework The importance of healthcare, the role of government, and reasons for the costs increase Financing

More information

OHIO. The European Union. Why the EU Matters for the Buckeye State. Indiana University. European Union Center

OHIO. The European Union. Why the EU Matters for the Buckeye State. Indiana University. European Union Center OHIO & The European Union Why the EU Matters for the Buckeye State Indiana University European Union Center Table of Contents Why does the EU Matter? 1 Ohio s Trade with the EU 2 The EU s Investments in

More information

Pan European Fire Strategy 2020 A safer Europe for all

Pan European Fire Strategy 2020 A safer Europe for all Federation of European Union (FEU) Fire Officer Associations www.f-e-u.org Pan A safer Europe for all Contents Context...3 Introduction...5 Who we are...6 Aims...6 Mission...6 Values...6 Vision...7 Objectives...7

More information

Voluntary health insurance and health care reforms

Voluntary health insurance and health care reforms Voluntary health insurance and health care reforms Sarah Thomson Senior Research Fellow, European Observatory Deputy Director, LSE Health IMF conference, Paris, 21 st June 2011 Health financing policy

More information

The Legal Protection Insurance Market in Europe. October 2013

The Legal Protection Insurance Market in Europe. October 2013 The Legal Protection Insurance Market in Europe October 2013 The Legal Protection Insurance Market in Europe October 2013 In its latest publication RIAD, the International Association of Legal Protection

More information

EPR Public Affairs e-bulletin

EPR Public Affairs e-bulletin EPR Public Affairs e-bulletin May 2015 European Platform for Rehabilitation, Rue de Spa 15, B-1000, Brussels, Belgium Tel: +32 2 736 54 44, Fax: +32 2 736 8622, Website: www.epr.eu Social Affairs & Social

More information

Consultation on the future of European Insolvency Law

Consultation on the future of European Insolvency Law Consultation on the future of European Insolvency Law The Commission has put the revision of the Insolvency Regulation in its Work Programme for 2012. The revision is one of the measures in the field of

More information

ASSOCIATION INTERNATIONALE DE LA MUTUALITE AIM CONTRIBUTION TO THE COMMISSION S GREEN PAPER ON THE EUROPEAN WORKFORCE FOR HEALTH

ASSOCIATION INTERNATIONALE DE LA MUTUALITE AIM CONTRIBUTION TO THE COMMISSION S GREEN PAPER ON THE EUROPEAN WORKFORCE FOR HEALTH Secretariat AIM ASSOCIATION INTERNATIONALE DE LA MUTUALITE ABOUT AIM AIM CONTRIBUTION TO THE COMMISSION S GREEN PAPER ON THE EUROPEAN WORKFORCE FOR HEALTH BRUSSELS, 2 APRIL 2009 The Association Internationale

More information

THE COST OF TAXES ON JOBS AROUND THE WORLD

THE COST OF TAXES ON JOBS AROUND THE WORLD THE COST OF TAXES ON JOBS AROUND THE WORLD HOW SOCIAL SECURITY PAYMENTS AND OTHER EMPLOYER COSTS IMPACT JOB CREATION AND WAGE GROWTH IN DIFFERENT ECONOMIES FEBRUARY 2016 CONTENTS Introduction 3 1 Key Findings

More information

Analysis of the determinants of workplace occupational safety and health practice in a selection of EU Member States

Analysis of the determinants of workplace occupational safety and health practice in a selection of EU Member States EN Safety and health at work is everyone s concern. It s good for you. It s good for business. Analysis of the determinants of workplace occupational safety and health practice in a selection of EU Member

More information

POST- CRISIS BUSINESS MODEL OF BANKS IN THE REGION

POST- CRISIS BUSINESS MODEL OF BANKS IN THE REGION POST- CRISIS BUSINESS MODEL OF BANKS IN THE REGION Dr. György Surányi Resident Regional Head 16-17, November, 29 BEFORE THE CRISIS: A MACROECONOMIC OVERVIEW 2 GDP GROWTH RATES WELL ABOVE THE EMU AVERAGE...

More information

COMMUNICATION FROM THE COMMISSION 2014 DRAFT BUDGETARY PLANS OF THE EURO AREA: OVERALL ASSESSMENT OF THE BUDGETARY SITUATION AND PROSPECTS

COMMUNICATION FROM THE COMMISSION 2014 DRAFT BUDGETARY PLANS OF THE EURO AREA: OVERALL ASSESSMENT OF THE BUDGETARY SITUATION AND PROSPECTS EUROPEAN COMMISSION Brussels, 15.11.2013 COM(2013) 900 final COMMUNICATION FROM THE COMMISSION 2014 DRAFT BUDGETARY PLANS OF THE EURO AREA: OVERALL ASSESSMENT OF THE BUDGETARY SITUATION AND PROSPECTS EN

More information

(OECD, 2012) Equity and Quality in Education: Supporting Disadvantaged Students and Schools

(OECD, 2012) Equity and Quality in Education: Supporting Disadvantaged Students and Schools (OECD, 2012) Equity and Quality in Education: Supporting Disadvantaged Students and Schools SPOTLIGHT REPORT: SPAIN www.oecd.org/edu/equity This spotlight report draws upon the OECD report Equity and Quality

More information

NERI Quarterly Economic Facts Summer 2012. 4 Distribution of Income and Wealth

NERI Quarterly Economic Facts Summer 2012. 4 Distribution of Income and Wealth 4 Distribution of Income and Wealth 53 54 Indicator 4.1 Income per capita in the EU Indicator defined National income (GDP) in per capita (per head of population) terms expressed in Euro and adjusted for

More information

U.S. DEPARTMENT OF THE TREASURY

U.S. DEPARTMENT OF THE TREASURY U.S. DEPARTMENT OF THE TREASURY Press Center Link: http://www.treasury.gov/press-center/press-releases/pages/hp1060.aspx Statement For the Record of the Senate Committee on Finance Hearing on International

More information

International Monetary and Financial Committee

International Monetary and Financial Committee International Monetary and Financial Committee Twenty-Ninth Meeting April 12, 2014 Statement by Ms. Jutta Urpilainen, Minister of Finance, Finland On behalf of Denmark, Estonia, Finland, Iceland, Latvia,

More information

EU Energy Policy and the Energy Situation in Germany

EU Energy Policy and the Energy Situation in Germany IIPS Japan Policy Commentary EU Energy Policy and the Energy Situation in Germany By Mikihiko Shimizu Senior Research Fellow at IIPS Introduction Japan s energy policy is undergoing fundamental review

More information

Fact and figures about intra-eu labour mobility

Fact and figures about intra-eu labour mobility Fact and figures about intra-eu labour mobility Laurent Aujean Employment analysis Unit DG Employment, Social Affairs and Inclusion Leuven, 13 October 2014 Social Europe Outline 1. Main figures on intra-eu

More information

Sustainable jobs, secure incomes and social protection

Sustainable jobs, secure incomes and social protection 3 rd ITUC World Congress 18-23 May 2014 Berlin Sustainable jobs, secure incomes and social protection Framework for Action INTERNATIONAL TRADE UNION CONFEDERATION Sustainable jobs, secure incomes and social

More information